Appeals Analyst - Remote

Overview

The Appeals Analyst is responsible for monitoring contractual allowances, analyzing and pursuing appeal opportunities with payers and networks, and reporting appeals performance.

In Short

• Implement processes for identifying under-allowed claims.
• Review and analyze EOBs for identified under-allowed claims.
• Verify applicable contracts and member information.
• Refine communication skills for preparing appeals.
• Batch appeals by payer or network.
• Compile and submit appeals, monitoring for reimbursement.
• Track appeals and outcomes using Contract Manager.
• Establish contacts in payer or network offices.
• Monitor contractual, billing, registration, and posting errors.
• Participate in meetings regarding managed care contracts.

Requirements

• Bachelor's degree in a related field or equivalent experience.
• Minimum two years experience with managed care claims.
• Experience with a Contract Manager application is a plus.
• Advanced PC skills and proficiency in Microsoft Office.
• Knowledge of healthcare billing and reimbursement.
• Familiarity with practice management systems and EOB imaging.
• Knowledge of medical terminology and managed care contracts.

Benefits

• Medical, life, and dental insurance.
• Flex work/work from home options.
• Paid time off and annual performance bonus.
• Education reimbursement and family bonding leave.
• Referral program and more.